Bihemispheric Infarct Stroke in a 65-Year-Old Elderly Patient with Bilateral Senile Cataract

Abstract

Bihemispheric infarct stroke is a complex clinical condition that may cause bilateral neurological deficits and increase the risk of recurrent stroke. Senile cataract may contribute to falls in older adults through visual impairment and is hypothesized to be associated with systemic oxidative stress, which also plays a role in atherosclerosis. This case report describes the diagnosis and initial management of bihemispheric infarct stroke in an elderly patient with bilateral senile cataract and discusses the possible association between these conditions. A 65-year-old man presented to the emergency department with right-sided limb weakness, slurred speech, and headache after falling in the bathroom. He had a history of left-sided weakness one year earlier, uncontrolled hypertension, and more than 20 years of smoking. Physical examination revealed bilateral hemiparesis, central-type right facial nerve palsy, and impaired visual acuity of 3/60 in the right eye and 2/60 in the left eye. Ophthalmological examination showed pseudophakia in the right eye and lens opacity in the left eye. Laboratory evaluation revealed elevated total cholesterol and LDL levels. Head CT demonstrated a chronic infarct in the right temporoparietooccipital region and an acute infarct in the left temporal lobe. The patient received supportive therapy, antiplatelet treatment, antihypertensive therapy, statin therapy, and adjuvant treatment. This case emphasizes the importance of comprehensive assessment of vascular risk factors, visual impairment, and previous stroke in elderly patients. In this case, senile cataract should be considered a comorbidity and a possible marker of systemic oxidative stress rather than a direct cause of stroke.